A nursing unit is undergoing changes to accommodate new bariatric services that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following actions should the charge nurse take?
Role model a positive approach to the changes.
Redirect the conversation when staff members make negative comments about the changes.
Encourage staff members who support the changes to discuss the issue with resistant staff.
Suggest that resistant staff members transfer to a different unit.
Reprimand staff members who are resistant to the changes.
Correct Answer : A,C
The correct answers are Choices A and C.
Choice A rationale: Modeling positivity leverages social learning and transformational leadership, sets constructive norms, reduces uncertainty, and promotes psychological safety, facilitating Lewin’s change movement and sustained adoption of bariatric workflows and equipment safely.
Choice B rationale: Redirecting negativity suppresses concerns, undermines just culture, and blocks feedback necessary for Lewin’s unfreezing, reducing trust, psychological safety, and data to address barriers, thereby entrenching covert resistance to change process.
Choice C rationale: Engaging supportive peers utilizes diffusion of innovations and social proof; peer dialogue surfaces practical barriers, shares tacit knowledge, normalizes change behaviors, and increases motivation and adherence to bariatric care practices.
Choice D rationale: Suggesting transfers is coercive and punitive, contradicting transformational leadership and just culture, damages morale and retention, bypasses root-cause analysis, and fails to address legitimate change barriers or build sustainable engagement.
Choice E rationale: Reprimanding resistance pathologizes normal adaptation, undermines psychological safety and voice, increases turnover intentions, entrenches oppositional behavior, and conflicts with evidence-based change management; reserve discipline for misconduct, not expressed skepticism alone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
A client who has a penetrating head injury and a respiratory rate of 4/min requires immediate attention due to the critical nature of the head injury and the dangerously low respiratory rate. However, in an emergency situation like this, the priority would be a condition that could be rapidly fatal if not addressed promptly.
Choice B rationale:
A client with a comminuted fracture of the femur has a serious injury that requires assessment and treatment, but it is not an immediately life-threatening condition. It falls lower in the priority compared to conditions that directly impact respiratory and cardiovascular function.
Choice C rationale:
A client with a 15.2-cm laceration to the scalp with clotted blood visible also requires attention, but it is not as time-sensitive as a life-threatening condition. Controlling bleeding and cleaning the wound can be addressed after addressing more critical cases.
Choice D rationale:
Correct. A client with a sucking chest wound has a high risk of tension pneumothorax, a condition where air accumulates in the pleural space, leading to lung collapse and compromised circulation. This condition can be rapidly fatal. Immediate intervention is required to seal the wound and prevent further air from entering the pleural space.
Correct Answer is C
Explanation
Choice A rationale:
Digoxin is a medication used to treat heart conditions like heart failure and atrial fibrillation. A digoxin level of 1.0 ng/mL is within the therapeutic range (usually 0.5-2.0 ng/mL), indicating that the client's digoxin dosage is appropriate. However, this value doesn't indicate an urgent need for a home visit.
Choice B rationale:
A white blood cell count (WBC) of 6,000/mm³ falls within the normal range (typically 4,500-11,000/mm³). While this value could suggest a stable immune system, it doesn't provide information requiring immediate attention or a home visit.
Choice C rationale:
Platelets are essential for blood clotting. A platelet count of 100,000/mm³ is significantly below the normal range (usually 150,000-450,000/mm³), indicating a risk of bleeding and potentially a serious medical condition. This client is at risk for spontaneous bleeding and requires prompt assessment and intervention, making this choice the correct answer.
Choice D rationale:
A serum potassium level of 4.0 mEq/L falls within the normal range (typically 3.5-5.0 mEq/L). While maintaining electrolyte balance is important, this potassium level doesn't indicate an immediate need for a home visit.
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